News Blog
21May

Register for the June CME: COVID-19 Looking to the Future

COVID-19 – Looking to the Future: Where are we now and where do we go from here? Presented by Texas Children’s Health Plan Wednesday, June 17, 2020 – 5:30-7:30 p.m. – Live stream via WebEx Topics covered will include: Progress toward a COVID-19 Vaccine Fall 2020: Managing COVID-19 and the Flu in a Pediatrics Practice Telemedicine: How to Keep the Momentum Going Q&A with Dr. Lisa Hollier The CME will be presented by: Dr. Mark Ward Director, Pediatric Residency Program Baylor College of Medicine/Texas Children’s Hospital Dr. Robert Ball Medical Director, eHealth Texas Children’s...

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Provider Alert!
21May

Provider Alert! Continuing Education Credit: Immunizations

Attention: Primary Care Providers and Pharmacists Effective Date: May 18, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Primary Care Providers as well as other interested healthcare professionals are encouraged to participate in this online course provided by the Health and Human Services Commission (HHSC)...

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Provider Alert!
20May

Provider Alert! Reminder: Authorization Guidelines for a hospitalized member – post discharge services and supplies

Attention: All Providers Effective Date: May 20, 2020 Call to action: Texas Children’s Health Plan (TCHP) is aligned with the Uniform Managed Care Contract (UMCC) Guideline for members with an authorization request during hospitalization (reference: 8.1.8 Utilization Management). The guideline states that TCHP must issue coverage determinations for a member who is hospitalized at the time of the request, within one Business Day of receiving the request for services or equipment that will be necessary for the care of the Member immediately...

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Provider Alert!
15May

Provider Alert! Continuing Education credit: Transition Services for Children and Youth with Special Health Care Needs

Attention Primary Care Providers Effective Date: May 15, 2020 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Primary Care Providers that care for members with special health-care needs are encouraged to participate in this online course provided by the Health and Human Services Commission (HHSC)...

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11May

Provider Alert! Families First Coronavirus Response Act Information

Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: This rule is in effect April 2, 2020 to December 31, 2020. Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: The United States Department of Labor (DOL) issued a temporary rule implementing...

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Provider Alert!
11May

Provider Alert! Live EVV Training Webinars in June

Attention: Existing Electronic Visit Verification (EVV) Users Effective Date: June 16-June 17 Call to action: In June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers currently required to use EVV. How this impacts providers: Program providers must complete EVV Portal training and EVV policy training annually. See the following link for more information: https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/evv/evv-required-training-checklist.pdf Next steps for providers: To meet the annual training requirement,...

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Provider Alert!
11May

Provider Alert! Cures Act EVV: Required EVV Training Webinars in May and June

Attention: Financial Management Services Agencies (FMSA) Effective Date: 6/2/2020 – 6/3/2020 Call to action: In May and June, the Health and Human Services Commission (HHSC) and Texas Medicaid & Healthcare Partnership (TMHP) will hold live Electronic Visit Verification (EVV) policy and EVV Portal training webinars for program providers and financial management service agencies (FMSAs) required to use EVV by the Cures Act. How this impacts providers: Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV Portal training and EVV policy...

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07May

Provider Alert! COVID-19 Medicaid Pharmacy Benefit Updated May 4, 2020

Attention: All Providers and Pharmacies Effective Date: May 4, 2020 The Texas Vendor Drug Program (VDP) has implemented several changes in response to COVID-19. This notice contains the latest updates, as well as links to the previously implemented changes. No-auto prior authorization (NAP) designation temporarily lifted: Normally, medications listed as NAP on the drug formulary by VDP require a manual hard stop in the system. Providers must call/fax to complete a prior authorization (PA) rather than allowing automated authorizations by reviewing historical pharmacy...

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Provider Alert!
07May

Provider Alert! Provider Incentive Program Updates

Attention: All PCP Providers Effective Date: May 7, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of changes to our Provider Incentive Program (PIP) Upper Respiratory Infection measure to align with the changes consistent with National Committee for Quality Assurance (NCQA) HEDIS technical specifications. The Health and Human Services Commission (HHSC) follows this guidance as well in their oversight of Managed Care Organizations. How this impacts providers: Updates include the following for measure, Appropriate Treatment for Upper...

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24Apr

World Immunization Week

The Centers for Disease Control recognizes the last week of April as World Immunization Week. World Immunization Week promotes the use of vaccinations to protect people of all ages against disease. According to the World Health Organization, immunizations prevent millions of deaths from diseases like diphtheria, influenza, pertussis (whooping cough), and others. Vaccinations work along with our body’s natural defenses to keep us and those around us from getting sick. Vaccinations have significantly decreased the mortality rate or deaths and disabilities...

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